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Opening with a scene of Chanda visiting a funeral home to buy a coffin for her baby sister, readers are quickly brought up to speed with the cold reality of death in sub-Saharan Africa. Chanda's feelings of shame and sadness are contrasted with the funeral home's shameless business of profiting from human suffering, and a funeral home owner who is patronizing and insensitive.

Chanda's Secrets takes place in a nameless country that accurately resembles a place where over a quarter of the population is living with HIV. Chanda's struggles are similar to those of millions of other children living in sub-Saharan Africa. Having lost her father, stepfather, three older brothers, sister, and several community members, Chanda quickly moves from the playful ignorance of youth to an adult life, even though it is difficult for her to understand some of what is happening around her.

Chanda is a mature, thoughtful protagonist who struggles to understand the world around her. Chanda struggles with many universal teenage issues. She is conflicted by what she wants in life versus what adults expect of her, she is bothered by the contradictions between what people say and do, and she questions her own intentions as she struggles to define who she is in a world where she is losing so much.

Secrecy and stigma are themes throughout the book, as might be expected from the title. The book confronts not only personal secrets around illness, but also sticky moral issues. Stratton encourages the reader to question the impact of secrets and also contradicts many myths and misinformation about HIV. Stratton portrays women with pride and dignity, putting prostitution and rape in perspective without making stereotypical judgments about lack of moral character. Without demonizing women, he confronts the difficult choices women and girls are asked to make in a poverty-stricken situation.

Though the Hollywood ending makes the story slightly unrealistic, teens who will never experience the struggles of a girl like Chanda may be given a face and a story to connect with the statistics they hear on the news.